Growth failure is highly prevalent in children with chronic kidney disease (CKD) both pre-and post-transplantation, and is a significant cause of morbidity and mortality. The causes of impaired linear growth may include protein energy malnutrition, chronic metabolic acidosis and anemia, recurrent infections, endocrinopathies, and steroid therapy. Despite aggressive supportive therapies, the condition persists and its impact on neurocognitive development is unknown. Identification of the molecular events controlling normal skeletal growth and development may: l ) allow better understanding of the pathophysiology of renal osteodystrophy and growth failure children with CKD; and, 2) direct new and improved therapies for these disorders resulting in the achievement of full growth potential and overall development. These goals serve as the basis for the International Pediatric Nephrology Association (IPNA)-sponsored Seventh Symposium on Growth and Development in Children with Chronic Renal Failure: The Molecular Basis of Skeletal Growth, to be held in Heidelberg, Germany, April 1-4, 2004. This conference builds on the success of the prior six such international scientific meetings and will continue to provide the opportunity for interaction between basic and clinical investigators studying skeletal growth and derangement secondary to CKD. Up to date scientific information regarding the molecular mechanisms for both normal and abnormal skeletal growth will be presented with the goal of developing new directions for research and treatment of the pathophysiology of growth failure in CKD. Participation of young investigators and trainees in nephrology and endocrinology with special consideration given to individuals who are underrepresented in science, will be a primary goal of this symposium and will be achieved by travel grants. Two poster sessions selected by the Scientific Organizing Committee will provide a forum for these participants to present their work for critical review prior to publication in a supplemental issue of the International Journal of Pediatric Nephrology. Meeting announcements via mail, journals, websites, and emails will reach the North and South American, European, Asian, and other International Societies of Pediatric Nephrology.